Chris King
Reporter, BBC Radio Stoke

I've been to the Royal Stoke University Hospital where junior doctors have joined a 48-hour national strike by their colleagues in a contract row with the government.

The walkout started at 08:00 and will last 48 hours, the longest one so far - but medics are once again providing emergency cover in hospitals.

The strike comes after ministers announced last month they would impose the new contract.

NHS bosses have warned the strike was going to be "difficult" for the health service, as the series of walkouts was beginning to take its toll.

Joe Harrison, who is the chief executive of Milton Keynes University Hospital, told BBC News: "We are running a full 24/7 emergency service. 

"All of the patients that were cancelled in the previous strikes - with the exception of one - have already been treated. 

"We've cancelled fewer patients over the next 48 hours than we did on either of the first two 24 hour strikes. 

"Our planning is getting better, fewer patients are being impacted and we're running a full emergency service."

Josh Brewin has been a junior doctor for seven months. He's joined the picket line at Milton Keynes General Hospital.

"There are still a few issues that the government haven't addressed, for example, a big issue for me is what they're defining as a night shift. 

"A night shift is counted as - in the new contract - from 2am onwards, so I could work until one minute to 2 am and that not count as a night shift. 

"That's going to have an impact on my rota and patient safety which is why we're here."

Image source, Getty Images

Doctors are out in force at Bristol Royal Infirmary for the start of a 48-hour strike.

While the strike is in place, junior doctors are running an "emergency care-only" model. 

Effectively, this means some of them will still be on rota to work in A&E and cover other emergency services in hospitals. But they will not do any non-urgent work - this will either be cancelled or picked up by colleagues.  

For more information on what patients need to know while the strike is ongoing, click here.

It is a bitterly cold and blustery morning on the picket line at the Royal Cornwall Hospital in Truro. 

Junior Doctors, wrapped warmly in hats and coats, are taking it in turns to shelter from the wind just inside the main entrance. 

The hospital is on black alert and admitted last week it was a challenge to maintain patient safety and dignity in an extremely busy A&E; last week I saw patients being treated in corridors on trolleys.  

Junior Doctors say the decision to strike is regrettable but claim that they are doing so partly to protect patient safety.

The BBC's health correspondent Sophie Hutchinson explains the row so far in this video.

If you've forgotten what this dispute is all about, click here for a quick explainer which brings you up to date with the situation as it developed.

Ministers originally drew up plans to change the doctors' contracts in 2012.

BBC Radio 5 Live

Doctor Reena Agawarl, a specialist registrar in obstetrics and gynaecology at Whittington Hospital in London, said striking was a last resort.

Dr Anne Rainsberry, national incident director for NHS England, said: "This is clearly going to be a difficult couple of days. 

"A 48-hour strike will put significantly more pressure on the NHS and the cumulative effect of these recurring strikes is likely to take a toll. 

"The safety and care of patients is always our number one priority and staff across the NHS are doing all they can to minimise the impact on patients of the action." 

Outside the Royal Sussex County Hospital in Brighton, passing motorists have been beeping their horns in support of the junior doctors on strike.

Orthopaedic registrar Christopher Gee said morale across the NHS was now at "an all-time low" amid uncertainty over the future of the NHS. 

He said: "It is very frustrating. Doctors feel they have been backed into a corner. We all very conclusively believe we have no other choice but to strike. We are trying to do everything we can to get the government to listen."

Image source, PA

The Green Party offered its support to striking doctors. 

Health spokesman, Larry Sanders - who is the brother of US presidential candidate Bernie - said: "The hypocrisy of Jeremy Hunt announcing that he was imposing a contract on junior doctors exactly one year after he 'called time on NHS bullying' is astounding. 

"Those junior doctors are essential to a functioning NHS and they will go on to become leaders of the service. They need to be treated with the respect that they deserve. 

"It is clear to all that Jeremy Hunt's agenda is to destroy the NHS and to pass it into private hands supported by an insurance scheme. He has gone on record with these views and he is therefore not a fit person to be in charge of the NHS."

Dr Johann Malawana, BMA Junior Doctor chair, has said union members "deeply regret disruption to patients". He said the BMA had given NHS trusts "as much notice as possible to plan ahead, but the government has left junior doctors with no choice". 

Nick Triggle
Health Correspondent

The problem now with this dispute is that the two sides have both retreated to entrenched positions. 

This is the first of three 48-hour strikes – the next two take place in April – while the British Medical Association is also looking to take legal action. 

But ministers are pushing ahead full-throttle with the imposition – the new contracts are due to go out in May ready for an August start date. 

In the meantime, the government seems to be simply hoping appetite for industrial action will wane and media attention is focused on Europe.